William M. Geisler, M.D., M.P.H., is a mid-career stage physician scientist at the University of Alabama at Birmingham (UAB) with independent federal funding, expertise in Chlamydia trachomatis (CT) infections, and significant experience in mentoring early career stage trainees in patient-oriented research (POR). This midcareer investigator award would enable Dr. Geisler to: 1) further develop his mentoring skills, 2) continue providing POR mentoring to early career stage trainees, and 3) expand his research program in new directions by supporting two new research projects. CT infections are highly prevalent in young females (adolescents and young adults) and can cause significant reproductive morbidity when untreated. Since the majority of CT infections are asymptomatic, they are often unrecognized and may go untreated. CT detection relies in large part on screening young females annually. Because provider compliance with CT screening is low and screening at an annual interval misses many infections that resolve spontaneously or are incidentally treated, the cumulative burden of CT infection in asymptomatic young females is unknown. Another missed opportunity for treating CT infection is in females with CT-associated dysuria who are misdiagnosed with a urinary tract infection (UTI), often prescribed UTI treatment ineffective against CT, and usually not tested for CT. With award support, Dr. Geisler plans to expand and refine his mentoring skills through didactics and training, and to continue mentoring his current early stage trainees and recruit new trainees through multiple UAB sources. All trainees will be provided with educational and research experiences tailored to their career stage and interests. With award support, Dr. Geisler?s research program will be augmented through two new studies addressing missed opportunites for CT detection and treatment, which will provide new opportunities for mentoring trainees, collaborations, and funding. The Aim of New Study 1 is: Evaluate the cumulative burden of CT infection in female adolescents and young adults and predictors of higher burden. Females ages 16-29 years will be enrolled at 4 UAB clinics with different patient populations. Subjects will be interviewed and undergo urine CT testing and serum CT antibody testing. Cumulative burden of CT infection represents positivity by either test. The Aim of New Study 2 is: Determine the frequency of CT infection in female adolescents and young adults presenting with dysuria and the patient and urine characteristics that distinguish CT infection from UTI. Females ages 16-29 years presenting to the UAB Emergency Department with dysuria will be enrolled, interviewed, undergo urogenital CT testing, and have a urine dipstick and bacterial culture performed. The long-term goal of Dr. Geisler?s research is to improve prevention and control of CT infection. Knowledge from the new studies could lead to improve CT screening strategies in young asymptomatic females and more testing and treatment in females presenting with CT-associated dysuria. The research studies will provide mentoring opportunities in POR for multiple early stage trainees.